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침습선암의 조직소견이 동반된 혼합형 증식성 선종성 직장용종 1예
서효림 ( Hyo Rim Seo ),김지현 ( Ji Hyun Kim ),정수진 ( Soo Jin Jung ),최윤정 ( Yun Jung Choi ),류충헌 ( Choong Heon Ryu ),박관식 ( Kwan Sik Park ),하승인 ( Seoung In Ha ),정은욱 ( Eun Uk Jung ),이상헌 ( Sang Heon Lee ),박성재 ( Su 대한장연구학회 2012 Intestinal Research Vol.10 No.3
Epithelial colon polyps are largely divided into hyperplastic and adenomatous polyps. Adenomatous polyps are premalignant lesions, whereas hyperplastic polyps are regarded as benign lesions. However, this histological classification has been blurred, as cases of malignant changes in hyperplastic polyposis, mixed hyperplastic adenomatous polyps (MHAPs), and serrated adenomas in the colon have been reported. Rare cases of MHAP have been reported, and are mainly found at the proximal colon with a relatively large size. MHAPs seem to be an intermediate stage of the hyperplastic polyp-adenoma sequence or a collision tumor. Here, we report on a case of a single polyp in the rectum diagnosed with a MHAP combined with an invasive adenocarcinoma. (Intest Res 2012;10:295-299)
부산지역 알레르기 클리닉을 내원한 환자들에서 점박이응애와 집먼지진드기의 감작률
서효림 ( Hyo Rim Seo ),이수미 ( Soo Mi Lee ),구태형 ( Tae Hyung Koo ),신봉철 ( Bong Chul Shin ),김보경 ( Bo Kyung Kim ),허정훈 ( Jeong Hun Heo ),양두경 ( Doo Kyung Yang ),이수걸 ( Soo Keol Lee ),손춘희 ( Choon Hee Son ) 대한천식알레르기학회 2007 천식 및 알레르기 Vol.27 No.4
Background: Recently, it has been demonstrated that the sensitization rate to two spotted mite (TSM, Tetranychus urticae) is as high as that to house dust mite (HDM) in respiratory allergy patients in the middle part of Korean peninsula. However, there are no published data on the sensitization rate to TSM in southern area of Korean peninsula. Objective: The aim of this study is to evaluate the sensitization rate to TSM in patients with allergic diseases in Busan area. Method: Skin prick tests were performed with 49 common inhalant allergens and TSM extracts on 519 patients with various allergic diseases between March 2005 and June 2007. We evaluated clinical characteristics and the sensitization rate to various inhalant allergens including TSM. Result: The sensitization rate to Dermatophagoides pteronyssinus (49.3%) was highest, followed by D. farinae (44.9%), TSM (32.9%), birch (17.0%) and mugwort (16.0%). Forty (7.7%) patients were sensitized to TSM only. Conclusion: TSM was the second most common sensitized allergen in patients visiting the allergy clinic in Busan area. These results suggest that TSM might be an important outdoor allergen in Korean peninsula. (Korean J Asthma Allergy Clin Immunol 2007;27:263-267)
급성세기관지염에서 전신 스테로이드제 치료에 따른 임상 양상
서효림 ( Hyo Rim Suh ),안지영 ( Ji Young Ahn ),최봉석 ( Bong Seok Choi ) 대한천식알레르기학회(구 대한알레르기학회) 2017 Allergy Asthma & Respiratory Disease Vol.5 No.6
Purpose: Previous studies have reported that clinical efficacy of steroid therapy for acute bronchiolitis is controversial. However, since it is still frequently used in clinical practice, we sought to re-evaluate its effectiveness. Methods: This study included 277 children with acute bronchiolitis who were admitted to Kyungpook National University Children’s Hospital from March 2013 to July 2016. Erythrocyte sedimentation rates, C-reactive protein (CRP) levels, and viral polymerase chain reaction testing results were obtained, and respiratory rate (RR) was measured periodically. Forty-eight patients were treated with an intravenous (IV) steroid (17.3%, IV group) and 19 patients were treated with a per oral (PO) steroid medication (6.9%, PO group). The remaining 210 patients were steroid-free patients (74.2%, nonsteroid group). Results: RR and CRP levels were higher in the IV group, along with a longer hospitalization period and duration of wheezing. The rate of change from the fastest initial RR to the mean RR on the first treatment day was greatest in the IV group; this finding was statistically significant after controlling for initial RR (16.06% in the IV group, 3.94% in the PO group, 4.90% in the nonsteroid group; P<0.01). Conclusion: There was a trend of IV steroid treatment toward more severe bronchiolitis. A significant reduction in RR on the first day of steroid treatment was observed in IV steroid-treated patients. IV steroid therapy may play a positive role in initial RR stabilization for severe bronchiolitis. (Allergy Asthma Respir Dis 2017;5:326-330)
정재훈,서효림,이동언,최재영,이소미,강빈,최병호 대한응급의학회 2019 大韓應急醫學會誌 Vol.30 No.4
The absence of a gallbladder is a very rare anomaly. While it is usually asymptomatic, it can cause biliary colic symptoms. For these reasons, gallbladder agenesis can be misdiagnosed as a hepatobiliary disease and is diagnosed correctly after surgery. This condition may also be detected through an autopsy for other causative diseases. Abdominal ultrasonography is used as a diagnostic method to detect gallbladder agenesis. Hepatobiliary scintigraphy, magnetic resonance cholangiopancreatography, and endoscopic cholangiopancreatography are also used to make a more accurate diagnosis. In the emergency room, however, gallbladder agenesis can still be misdiagnosed as acute or chronic cholecystitis, leading to the detection of gallbladder agenesis in the operating room. Although some cases of gallbladder agenesis detected in adults during surgery have been reported in Korea, there are no reports of gallbladder agenesis in pediatric patients to date. This paper reports a case of gallbladder agenesis in a symptomatic child that was detected incidentally by a radiographic examination.
조태경,서효림,최보금,권정은,정한나,이영옥,조준용,김여향 대한소아청소년과학회 2018 Clinical and Experimental Pediatrics (CEP) Vol.61 No.7
Purpose: The present study aimed to evaluate progression and prognosis according to the palliation method used in neonates and early infants aged 3 months or younger who were diagnosed with pulmonary atresia with ventricular septal defect (PA VSD) or tetralogy of Fallot (TOF) with severe pulmonary stenosis (PS) in a single tertiary hospital over a period of 12 years. Methods: Twenty with PA VSD and 9 with TOF and severe PS needed initial palliation. Reintervention after initial palliation, complete repair, and progress were reviewed retrospectively. Results: Among 29 patients, 14 patients underwent right ventricle to pulmonary artery (RV-PA) connection, 11 palliative BT shunt, 2 central shunt, and 2 ductal stent insertion. Median age at the initial palliation was 13 days (1–98 days). Additional procedure for pulmonary blood flow was required in 5 patients; 4 additional BT shunt operations and 1 RV-PA connection. There were 2 early deaths among patients with RV-PA connection, one from RV failure and the other from severe infection. Finally, 25 patients (86%) had a complete repair. Median age of total correction was 12 months (range, 2–31 months). At last follow-up, 2 patients had required reintervention after total correction; 1 conduit replacement and 1 right ventricular outflow tract (RVOT) patch enlargements. Conclusion: For initial palliation of patients with PA VSD or TOF with severe PS, not only shunt operation but also RV-PA connection approach can provide an acceptable outcome. To select the most proper surgical strategy, we recommend thorough evaluation of cardiac anomalies such as RVOT and PA morphologies and consideration of the patient’s condition.
Clinical Characteristics of Febrile UTI First Developed Over 5 Years of Age
노다은,서효림,민소윤,조태경,백희선,조민현 대한소아신장학회 2017 Childhood kidney diseases Vol.21 No.1
Purpose: Febrile urinary tract infection (UTI) is one of the commonest bacterial infections in children. The purpose of this study is to investigate the clinical characteristics of the first episode of febrile UTI occurring in children over 5 years compared to those in infants younger than a year. Methods: We retrospectively reviewed the medical records of 10 patients over 5 years, having febrile UTI, and 25 controls under 1 year. Clinical characteristics including symptoms at admission, the time interval between symptom onset and hospital visit and/or diagnosis, duration of fever, urinalysis, and other laboratory and imaging test results were compared between the two groups. Results: Most patients in the control group showed only high fever at the time of presentation to the hospital. However, 60% of the case group had fever along with gastrointestinal (GI) symptoms such as abdominal and flank pain, vomiting, as well as relatively mild pyuria. The case group showed a longer duration between symptom onset and hospital visit and/or diagnosis. Conclusions: Delay in diagnosis and initiation of treatment of UTI increases the risk of permanent renal scarring and associated complications. Therefore, early diagnosis and treatment of febrile UTI is vital for very young infants, as well as children considering that febrile UTI could be an important cause of febrile illness in children over 5 years.